Cook Incorporated

Cook Incorporation

Constantin Cope

Scott E Boatman

Mark Allen Magnuson

Joseph W Roberts

Hans A Timmermans

Patty J Arnett

Mark A Griffin

A system for permitting substantially bloodless percutaneous entry into an artery or vein of a patient. The system comprises a needle assembly, a needle hub attachment assembly having a hemostatic segment, and a wire guide inserter (curve straightener) or a wire guide holder also having a hemostatic segment. The components are assembled in a leak-free arrangement, and a fluid passageway for withdrawing blood is established through the system. Each of the hemostatic segments opens to permit passage of a wire guide therethrough, but re-seals to prevent flow of blood therethrough. The needle hub attachment assembly preferably includes a fluid-receiving chamber to permit the clinician to see the first squirt of blood as it enters the system.

Bloodless percutaneous insertion system

A method and the apparatus for anastomosing two hollow viscera that can be performed percutaneously or through the patients mouth. The apparatus includes an anchor assembly including a stationary T-bar anchor secured to the distal end of a suture and a sliding anchor that is attached to the suture proximal to the stationary T-bar anchor. The sliding anchor is held in place on the suture but can be slid along the suture when pressure is applied to it. The anchor assembly is inserted through the abdominal wall, into the stomach, and then through the stomach into the jejunum. The stationary anchor is then released into the jejunum and the sliding anchor is released in the stomach. A pusher is then used to push or slide the sliding anchor distally until the tissue between the stationary and sliding anchors are in close contact. After the anchor has been placed, the suture can be severed at the sliding anchor.

Sliding suture anchor

A suture anchor device, a visceral anchor for anchoring a viscus to a body wall, a kit for anchoring a viscus to a body wall and a method for anchoring a viscus to a body wall are described. The method and device reduce the probability of injuring the interior of a viscus as a large gauge needle is not required to deliver the visceral anchor. In one embodiment, the distal end of the visceral anchor may function as a dilator.

Suture anchor device

An catheterization apparatus 10 for reversing the retrograde or antegrade direction of catheterization includes a guide wire 12 foldable upon itself for partial introduction into a vessel 68 of a patient. The guide wire 12 first includes a resilient, elongated member 14 having a curved end 16 and a remainder 17 having a second, bent end 18. The guide wire 12 also includes a flexible tether 22 connected to the tip 20 of the curved end 16 of the elongated member 14. The elongated member 14 is preferably formed from a wire core or mandrel 24 covered by a continuous coiled wire 30. The catheterization apparatus 10 preferably further includes a catheter through which the guide wire 12 is introduced into the vessel 68. The catheter can be of conventional construction and operability. Preferably, however, the catheter is a highly flexible and relatively short intermediary catheter 56, employed only temporarily during use of the retrograde-antegrade guide wire 12. The catheterization apparatus 10 can also include an inserter sheath 60 engageable with the catheter 56 to facilitate passage of the guide wire 12 through the catheter 56. The apparatus 10 is particularly advantageous in that its use avoids the need to establish a second access site. Moreover, the apparatus 10 is relatively simple and reliable in construction and use, and is relatively low in cost, at least in comparison to the costs and risks of the establishment of a second access site. The apparatus 10 is atraumatic during use, that is, it does not significantly damage the blood vessel or other vessel during reversal of the direction of catheterization. The apparatus 10 is useful in vessels of both large and small diameter, and facilitates the selective engagement of a catheter with a bifurcation branch in a vessel.

Retrograde-antegrade catheterization guide wire

A method and apparatus for creating abdominal visceral anastomoses. A first magnet is placed within a first viscera and a second, larger magnet is placed within a second viscera. The magnets each have a raised rim around their perimeters. The two magnets couple to each other by virtue of their mutual attraction, thereby capturing a portion of the intervening visceral walls between them. The coupling of the magnets is automatically self-centering, as the smaller magnet is forced to rest within the raised rim of the larger magnet. Additionally, the raised rim of the smaller magnet acts as a fine cutting edge in order to accelerate the process of ischemic necrosis of the tissue captured between the two magnets, thereby forming the anastomosis. Use of the present invention avoids the need for general anasthesia and a laparotic incision, resulting in fewer surgical and post-surgical complications.

Method and apparatus for creating abdominal visceral anastomoses

An introducer set including a sheath and dilator is formed within a heated mold to form a smooth external shape on the set. In one embodiment, the distal end of the sheath is embedded in the dilator and also formed at an angle oblique to the longitudinal axis of the introducer set. In a second embodiment, the distal end of the sheath contacts the dilator at a ledge or lip formed in the dilator, but is not recessed into the dilator at the ledge portion. The outer diameter of the dilator at the transition is formed relatively the same as the distal tip of the sheath so as to provide a smooth transition between the sheath and the dilator. This construction permits the sheath to be inserted into the body with a minimum of trauma to the patient and also permits easy removal of the sheath from the dilator.

Smooth transitioned dilator-sheath assembly and method

An introducer set including a sheath and dilator is formed within a heated mold to form a smooth external shape on the set. The distal end of the sheath is embedded in the dilator and also formed at an angle oblique to the longitudinal axis of the introducer set. This construction permits the sheath to be inserted into the body with a minimum of trauma to the patient and also permits easy removal of the sheath from the dilator.

Recessed dilator-sheath assembly and method

A visceral anchor and method for visceral wall mobilization is disclosed. The visceral anchor includes an elongated cross bar to which a suture is attached at a location substantially in the center of the cross bar. The cross bar further includes a helical spring sheath which jackets a rigid rod, the sheath extending beyond the ends of the rod to form flexible ends. An alternative embodiment includes a second suture attached to one of the ends of the cross bar. The sutures are used for orienting the anchor during insertion into and removal from a hollow viscus. The method of visceral wall mobilization includes providing a tract through the skin into a hollow intra-abdominal viscus and inserting the anchor into the viscus lumen. The sutures extend through the tract and the unattached ends remain on the outside of the body. The center suture is pulled to orient the anchor for mobilization of the visceral wall. The end suture is pulled to orient the anchor for removal.

Visceral anchor for visceral wall mobilization

A stone retrieval basket having superelastic metallic alloy wires attached to the distal end of an inner elongaged member tube for retrieving calculi and crushing them against an outer introducer tube percutaneously inserted into a patient. The basket comprises kink-resistant superelastic metallic alloy wires such as nitinol forming a bulbous shape for capturing calculi therein. The ends of the superelastic wires of the basket are attached to the distal end of a inner elongated member tube with the aid of sleeves crimped thereon, which are soldered or spot welded in recesses about the distal end of the inner tube. The outer tube is percutaneously inserted into the biliary or urinary system in which the basket is then inserted to capture large-sized stones. A peel-away sheath is also included to introduce the basket and inner elongatged member tube into the outer introducer tube. A dilator member, which is extendable through the passageway of the inner tube, removes any residual debris from the tube that may be left during the stone removal procedure.

Medical retrieval basket

An introducing catheter for use with a pair of different diameter wire guides, the larger of which is a J-type wire guide, is provided in order to enlarge a tract to facilitate the passage of a drainage catheter through the tract. The introducing catheter includes an inwardly curved portion which lies between the distal and proximal ends of the catheter with the curved portion being located nearer to the distal end. The catheter also has a flexible tapered tip at its distal end and a lumen which decreases in area towards the distal end. The catheter further has a side port which is distally positioned from the curved portion and on the inward side of the curved portion so that when a J-type wire guide is advanced within the catheter from the proximal end, the wire guide will automatically emerge through the side port. The side port has an oval or elliptical shape with its major axis along the length of the tube. The catheter lumen has a diameter at the distal end which is substantially smaller than the minor axis diameter of the side port so that a wire guide having a substantially smaller external diameter than that of the J-type wire guide may be used as a guide for the catheter distal end. The introducing catheter is radiopaque, so that its position within a body can be monitored. The introducing catheter has a base portion at the proximal end for grasping and manipulating the catheter during a catheterization.

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Elkins Park, PA, United States of America

Constantin Cope